Common Causes Of Pulsatile Tinnitus
Tinnitus is a type of sensation that causes patients to hear certain sounds from inside the body as opposed to outside of it. While a ringing noise is the most commonly heard with standard tinnitus, these sounds can also be described as whistling, buzzing, hissing, grinding, or humming. Pulsatile tinnitus is unique in that the sounds patients hear match the rhythmic beating of their heart. The sound patients will experience with this form of tinnitus is the sound of blood circulating through the body. For standard types of tinnitus, it's currently unknown what causes the sounds to occur. However, pulsatile tinnitus can have several different sources for the noise, which makes treatment more viable.
Overactive Thyroid Gland
Pulsatile tinnitus usually occurs because the ear is aware of certain changes that have taken place in the blood flow of nearby vessels, which can include blood vessels in the ear or neck. An overactive thyroid gland, regularly referred to as hyperthyroidism, is among the most common causes of pulsatile tinnitus. This condition will result in quick and loud blood flow. The thyroid is located around the bottom portion of the neck directly above the collarbone. This gland directly controls the pace of the heartbeat as well the individual's ability to burn calories. This gland plays a substantial role in regulating the metabolism levels in the body. It's possible for the thyroid to produce too much of a certain hormone that helps with the regulation of metabolism. This hormone is called thyroxine and can cause a variety of unpleasant symptoms if left untreated, including mood swings and nervous feelings to losing high amounts of weight suddenly and experiencing tremors in the fingers and hands. Since a higher production of thyroxine results in a fast heartbeat, it's common for affected individuals to suffer from pulsatile tinnitus as well.
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Irregular Blood Vessels
The presence of irregular blood vessels, which occurs when blood starts to flow through vessels that have become damaged or twisted for some reason, can result in pulsatile tinnitus. The damaged blood vessels will typically be located near the ear or within the brain. When these blood vessels have been damaged, patients will experience a change in the noise and pressure that occurs with their blood flow. It's also possible for certain veins and arteries in the neck to cause this sound. If individuals believe a damaged blood vessel may be the cause of their pulsatile tinnitus, it's important to have this problem checked immediately. The issue with damaged blood vessels is they can weaken blood flow in the body and possibly rupture in certain situations. Both of these problems can make for severe complications, which is why early treatment is highly recommended.
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Head And Neck Tumors
A surprisingly common cause of pulsatile tinnitus is the presence of head and neck tumors, which is something individuals will want to have diagnosed early so the tumor can be treated before it worsens and spreads. Depending on where the tumor is located, it's possible for it to press down directly onto a blood vessel in the head or neck, which creates loud noises the individual will likely be able to hear. Causes and risk factors for these types of tumors and resulting cancers include radiation exposure, poor oral health, and the high consumption of foods that were salted or preserved in some way. The main locations for tumors that can cause pulsatile tinnitus include the oral cavity, larynx, and salivary glands.
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High Blood Pressure
High blood pressure is a condition that will increase an individual's risk of suffering from a stroke or heart disease. There's also a chance the quickened heart rate caused by high blood pressure will result in pulsatile tinnitus. When blood pressure reaches a high level, it's possible for too much pressure to be placed against artery walls, which can lead to a wide array of severe health complications individuals should be aware of. Along with a stroke or possible heart disease, potential complications include dementia, narrowed blood vessels in the kidneys, and aneurysms. The increased blood pressure through the arteries may be picked up by the individual's ears, causing pulsatile tinnitus until the blood pressure is lowered.
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Atherosclerosis
Atherosclerosis is a type of condition that causes arteries to become hardened. In the event cholesterol and similar fats start to clog some blood vessels, these vessels will invariably become less flexible, which is what can bring about this condition. Because of the lessened flexibility, the blood that flows around the inner and middle ear will be sent through with more force than normal. This particular condition is unique among the others on this list as it will usually affect both ears. The presence of atherosclerosis can increase an individual's risk of suffering a stroke or heart attack. Patients can prevent this condition by doing things such as managing their cholesterol, diabetes, and stress, as well as exercising regularly.
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Arteriovenous Malformation
An arteriovenous malformation is a defect of the blood vessels that is usually present at birth. The defect causes an abnormal connection between the veins and arteries that may produce a variety of symptoms. Arteriovenous malformations can form anywhere in the body, including the brain, spinal cord, limbs, and chest. Patients who have a malformation of the blood vessels in the brain could experience headaches, tinnitus, seizures, confusion, and weakness or numbness along one side of the body. To diagnose a malformation, doctors will perform a physical examination, including a complete neurological exam. The patient will have their vision and hearing tested, and the physician will also examine the patient's strength, sensation, gait, and coordination. CT scans and MRI scans are needed to confirm the presence of an arteriovenous malformation. Patients may be provided with pain medications, and they may also need to take anticonvulsants. Surgical interventions, including conventional surgery, radiosurgery, and endovascular embolization may be appropriate for repair or removal of the malformation.
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Turbulent Blood Flow
In healthy individuals, blood normally flows throughout the body in a smooth and regular laminar pattern. Patients with certain medical conditions may develop turbulent blood flow that results in an irregular, chaotic, and non-linear pattern of blood flow. This type of flow is very noisy, and it can cause pulsatile tinnitus for some patients. Turbulent blood flow is particularly common in patients with carotid artery disease and in individuals who have problems with the aorta. Doctors can typically hear turbulent blood flow by placing a stethoscope over the affected area. To evaluate blood flow, patients will need to have ultrasound scans, and CT scans, MRI scans, and other specialized scans may be needed to provide more detailed information. In the case of pulsatile tinnitus, doctors may need to check whether the patient's symptoms disappear when gentle pressure is applied to the jugular vein, and a balloon occlusion test may be advised in rare cases. Cases of turbulent blood flow caused by cardiac issues may be successfully treated with surgical interventions. However, pulsatile tinnitus is not currently curable.
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Anemia
Anemia occurs when there is a low red blood count, and it can be due to an iron deficiency. Patients with anemia often have symptoms very similar to those associated with stress. For example, anemic patients frequently have pulsatile tinnitus, and they may also experience fatigue, headaches, weakness, and pale skin. Brittle nails, heart palpitations, and increased blood flow in the jugular vein may occur with anemia too. Simple blood tests can be used to diagnose anemia. Depending on the cause, patients may need to be treated with iron supplements, and certain individuals may need to take folic acid or vitamin B12 supplements, too. In cases where anemia is caused by internal bleeding, doctors will need to identify the source of this bleeding, and surgery may be needed to stop it. Some individuals may need blood transfusions if they are severely anemic. During treatment for anemia, patients will be closely monitored by their healthcare team, and frequent blood tests might be necessary to measure blood counts and determine the effectiveness of any prescribed treatments. Patients may notice a reduction in their tinnitus symptoms once their anemia is treated, and they should always let their healthcare provider know if the tinnitus or other symptoms get worse.
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Intracranial Hypertension
Intracranial hypertension refers to a set of neurological conditions that cause elevated cerebrospinal fluid pressure in the brain. These conditions may be acute or chronic, and they can be caused by underlying medical conditions. Sometimes, the cause of a patient's intracranial hypertension may be unknown. Symptoms associated with intracranial hypertension typically include pulse-synchronous tinnitus (a whooshing or humming sensation in one or both ears in sync with the patient's pulse), vision changes, and headaches that are often excruciating. Patients could also experience pain in the shoulders and limbs, and they may feel nauseous or dizzy. To diagnose this condition, doctors generally perform a spinal tap. Treatment for intracranial hypertension may include medications such as acetazolamide and carbonic anhydrase inhibitors, and some patients may benefit from surgical options, including different types of shunts and a procedure known as optic nerve fenestration.